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General NPI Number Information
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NPI Number | 1306046297
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Entity Type | Individual
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Provider Name | HAL PHILLIPS O.D
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Gender | Male
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 9261 MIDDLEBROOK PIKE STE 201
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City | KNOXVILLE
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State | TN
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Zip | 37931-4799
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Country | US
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Telephone | 865-690-9909
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Fax | 865-690-9901
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Provider Business Mailing Address
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Address Line | 9261 MIDDLEBROOK PIKE STE 201
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City | KNOXVILLE
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State | TN
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Zip | 37931-4799
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Country | US
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Telephone | 865-690-9909
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Fax | 865-690-9901
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2731
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License Number State | TN
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